Individual
JANE L SELLERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
580 MOHAWK DR, BOULDER, CO 80303-3712
(303) 338-4545
Mailing address
580 MOHAWK DR, BOULDER, CO 80303-3712
(303) 338-4545
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
377
CO
363A00000X
Physician Assistant
Primary
377
CO
363A00000X
Physician Assistant
PA01203
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005349
KAISER-COMMERCIAL NUMBER
—
05
—
26205211
—
CO
Enumeration date
03/22/2007
Last updated
05/02/2014
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